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PLAN REVIEW CHECKLIST FOR NEW TRUCTURES / ADDITIONS <br /> Address: V C�aCI'�1 Permit No.: <br /> Description of work: G /�� ✓� � //' �U 61' Date Rec'd: <br /> Septic review by: Date Approved: <br /> Zoning review by: Date Approved: <br /> Building review by: Date Approved: �17�2 <br /> Grading review by: Date Approved: <br /> Zoning District: Zoning File M <br /> Resolution? Yes Reso M Reso Date: Signed: Yes No Resolution /NA <br /> Zoning: Lot Area: SF/AC Width: Structural Coerage: SF % <br /> Survey Submitted: 0 Yes 0 No Date of Survey: ' Revised dateM: <br /> Landscape plan submitted? 0 Yes Landscaper: i 0 No/None proposed <br /> Proposed Setbacks: <br /> Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland <br /> SideSide <br /> i <br /> Buildina Hei ht Analysis: <br /> Distance Between First Floor and defined Top ofoo (See "building height" (a) <br /> definition <br /> First Floor Elevation from building plans): (b) <br /> Highest Existing ground level (per survey)or 10' ab ve lowest ground level, M <br /> whichever is lower: <br /> Difference between b and (c)*: z (d) <br /> DEFINED HEIGHT <br /> *If highest existing adjacent grade is aboveFE-Height is )-(d): (e) <br /> *If highest existingadjacent rade is below FFE-Height is + d <br /> Shoreland District MCW Permit Average Lakeshore Setback Bluff <br /> Met? <br /> 0 Yes 0 No Permit Number- 0 Yes 0 No 0 N/A 0 Yes 0 No <br /> 0 N/A—see ttached Setback: <br /> Stormwater Quality /Existing Propos d <br /> Overlay District Tier ardcover Hardcov r Variance Required CUP Required <br /> circle one (% and sf (% and s <br /> 0 Yes 0 No 0 Yes 0 No <br /> 1 2 3 4 5 Type(s): Type(s): <br /> Updated: June 2017 <br /> zAforms\plan review checklist 06-2017.docx <br />